Don’t Slack on Slip-and-Trip Safety

Staff Safety Waste Management

By: Danielle Bouchat-Friedman | Senior Editor

Published: 10/25/2021

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Minimize risks and lean into specialized equipment to keep your staff upright.


Kathy Beydler, RN, MBA, CNOR, CASC, has seen her fair share of slips and trips in the OR — some resulting in significant injuries and missed work time — during her time as a nurse and outpatient surgery center administrator. “A friend of mine got her foot tangled in an improperly placed kick bucket, which caused her to fall and hurt her knee,” says Ms. Beydler. “She was out of work for a few weeks and had to do physical therapy.”

These days, Ms. Beydler sees the operating room through a different set of eyes. As a surveyor and principal consultant at Whitman Partners in Memphis, Tenn., she conducts accreditation surveys. “When I go into a surgery center or hospital, one of the dangers they’re accredited on is slips, trips and falls, and providing proper safety for their staff and patients,” says Ms. Beydler. “If the environment presents hazards, then they must be addressed in the accreditation report.”

During surveys, Ms. Beydler points out areas where facilities might be vulnerable. “If you work in the same OR every day, you might not notice obvious hazards,” she says.

One issue she has noticed at several facilities is the lack of a drip pan below motion-sensor hand sanitizer dispensers. “Even if you don’t put your hands under one, they can easily go off if you’re close enough,” says Ms. Beydler. “This leads to the foam dripping onto the floor, which creates a slipping hazard. I just cited a facility for that.”

Ms. Beydler says she’s also cited facilities for having equipment power cords that were too short, which essentially makes staff feel like they’re playing jump rope. “When cords are too short or you don’t have them placed properly, your staff is certainly at risk of tripping,” she says.

Although there are many risks to worry about in surgery, Ms. Beydler urges surgical leaders to focus on preventing slips, trips and falls. “It only takes one person to have their life completely impacted,” she says. “It could be a broken arm or a broken leg, which is not something any facility wants to deal with.”

Ms. Beydler says there is plenty of equipment on the market that can make your OR safer, such as power strips, cord covers and fluid management systems, and surgical leaders should spend time researching their options. 

Safety-centered solutions

HEADS UP Lakeland Surgical & Diagnostic Center installed two electrical receptacles in each of their four operating rooms, which consolidate the cords, as they provide electrical power to an operating room in one convenient and centralized location.  |  Nikki Williams

ORs are filled with all types of equipment, which can lead to a tangled mess of cords on the floor. “You can’t use extension cords, but you can use certain power cords,” says Ms. Beydler. “They have to be a specific type of power cord that has been approved. Many of the available power strips on the market come with up to 12 outlets and a 15-feet cord to provide power distribution.”

Cord covers may sound like an obvious solution, but many surgical teams are still covering cords with blankets or towels, which can easily tangle up a busy provider’s feet. Ms. Beydler recommends using orange cord alerts, which are bright and easy to see. They are inexpensive and easy-to-remove and dispose of, which also helps prevent the spread of floor-based contamination. “These cord alerts don’t take a lot of effort to install, but it’s that extra forethought that can protect your staff,” says Ms. Beydler. Floor- or ceiling-equipment-mounted booms, which limit the number of video towers and equipment carts needed around the surgical table, are common in newer facilities. The booms keep cords off the floor, but they are pricey, warns Ms. Beydler.

It just takes one person who could have their life completely impacted by a slip, trip or fall.
— Kathy Beydler, RN, MBA, CNOR, CASC

Your best bet is taking some time to study how equipment is placed in your ORs. “Get key players together to discuss the best solutions for preventing trips and falls,” says Ms. Beydler.

She recommends letting frontline staff lead the discussion, asking them to define the problem and the risks, and then look at how they can solve it. “Your team is more likely to buy in to the changes if they’re involved in coming up with the solution, because they’re the ones who are in the OR every day,” she says.

Lakeland (Fla.) Surgical & Diagnostic Center is a busy multispecialty surgery center that utilizes a lot of equipment that needs to be plugged in. The center’s staff relies on the orange cord alerts, because their bright color is easy to see and they won’t lift up when you walk over them. There are also two strategically placed electrical receptacles in each of the center’s four operating rooms. “They consolidate the cords, as they provide power in one convenient and centralized location,” says Executive Director Nikki Williams, RN, CNOR. “We also installed an epoxy flooring in our ORs. The rubber, non-stick surface really makes a difference.”

Still, says Ms. Williams, there’s always a risk that someone is going to trip and fall. She recalls a time when a staff member tripped over a laundry bag that was out of place and ended up with a fractured elbow. Even Ms. Williams has fallen victim. “I was walking through the OR and my foot got caught on a wheel, causing me to trip and hurt my knee,” she says.

For fluid-intensive cases, such as arthroscopic and gynecologic procedures, surgical teams also rely on direct-to-drain fluid collection systems or drapes equipped with fluid collection pouches. “I’ve also seen big rolls of disposable padding used in many surgery centers, which are certainly an option,” notes Ms. Beydler. “Anything that soaks up excess fluid so it doesn’t pool on the floor will do the trick. Fluid on the floor creates an electrical hazard as well, which certainly goes beyond slipping risks.”

By the Numbers

Surgical leaders are aware that slips, trips and falls happen, but they might be surprised to learn just how frequently they occur. Falls, slips and trips represented the second most common nonfatal occupational injury event to registered nurses and accounted for 25% of all injuries and illnesses occurring to nurses, according to a report by the United States Bureau of Labor Statistics (BLS). Many of the millions of nurses in the nation face workplace hazards in performing their routine duties. According to the BLS data, workplace hazards for nurses in 2016 resulted in 19,790 nonfatal injuries and illnesses — at an incidence rate of 104.2 cases per 10,000 full-time workers — that required at least one day away from work. 

Increased awareness

STAY ALERT Even a misplaced kick bucket can cause a busy provider to trip and fall.

Ms. Williams says it’s important to make your staff aware of any slipping and tripping incidents that have happened. “Leadership is often aware, but staff can sometimes be left out of the conversation,” she says. “I created a PowerPoint presentation for my staff so they could see how easily these things can happen.”

Although busy surgery centers often focus on quick room turnovers, Ms. Williams believes this can’t be an excuse for putting slipping, tripping and falling hazards on the back-burner. “We need to keep our staff safe. You don’t know what type of injury could be sustained, which is a loss for the center and pain and suffering for the employee,” she says. “There is always a risk someone is going to trip and fall when they are rushing, but these accidents are preventable.” OSM

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